Neuroimaging findings in isoniazid central nervous system toxicity, presumed intramyelinic edema

We describe the clinical course and striking neuroimaging findings of a child with central nervous system toxicity due to isoniazid. Serum isoniazid level was in the toxic range, the result of a dispensing error as well as a possible pharmacogenetic factor. We postulate that these imaging findings were the result of intramyelinic edema, previously described in experimental animal models of isoniazid toxicity.